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A Disruptive Technology: Determining Need for Permanent Pacing After TAVR

  • Invasive Electrophysiology and Pacing (E. Kevin Heist, Section Editor)
  • Published:
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Abstract

Purpose of Review

Transcatheter aortic valve replacement (TAVR) has changed the paradigm for management of severe aortic stenosis. Despite evolution of TAVR over the past 2 decades, conduction system disturbances remain a concern post-TAVR. In this review, we describe (1) permanent pacemaker (PP) implant rates associated with TAVR, (2) risk factors predicting need for PP therapy post-TAVR, (3) management of perioperative conduction abnormalities, and (4) novel areas of research.

Recent Findings

Conduction disturbances remain a common issue post-TAVR, in particular, left bundle branch block (LBBB). Though newer data describes resolution of a significant fraction of these disturbances over time, rates of pacemaker therapy remain high despite improvements in valve technology and procedural technique.

Summary

Recent consensus statements and guideline documents are important first steps in standardizing an approach to post-TAVR conduction disturbances. New areas of research show promise in both prediction and treatment of conduction disturbances post-TAVR.

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Authors and Affiliations

  1. Division of Cardiology, Cardiac Electrophysiology Section, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA

    Amneet Sandhu & Wendy S. Tzou

  2. Division of Cardiology, Denver VA Medical Center, Denver, CO, USA

    Amneet Sandhu

Authors
  1. Amneet Sandhu
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  2. Wendy S. Tzou
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Correspondence to Wendy S. Tzou.

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Dr. Sandhu has nothing to disclose. Dr. Tzou reports personal fees from Medtronic, Boston Scientific, and Biotronik, and grants and personal fees from Abbott.

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This article is part of the Topical Collection on Invasive Electrophysiology and Pacing

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Sandhu, A., Tzou, W.S. A Disruptive Technology: Determining Need for Permanent Pacing After TAVR. Curr Cardiol Rep 23, 53 (2021). https://doi.org/10.1007/s11886-021-01481-8

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